Publications by authors named "Natalia Pavone"

21 Publications

  • Page 1 of 1

Bicuspidized De Vega for functional tricuspid valve regurgitation: "De-Kay repair".

Ann Thorac Surg 2021 Apr 27. Epub 2021 Apr 27.

Department of Cardiovascular Science, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome.

Functional tricuspid valve regurgitation in the contest of mitral valve disease is a highly prevalent disease. We describe a ring-less technique that combines restrictive annuloplasty (De Vega) with posterior tricuspid leaflet obliteration (Kay) used for patients with less-than-severe functional tricuspid valve regurgitation undergoing mitral valve surgery. The technique has been in use at our centre since 2012, showing promising long-term echocardiographic results, with stable reduction of the annulus size and stable reduction of the degree of regurgitation.
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http://dx.doi.org/10.1016/j.athoracsur.2021.04.038DOI Listing
April 2021

Telemedicine for adult congenital heart disease patients during the first wave of COVID-19 era: a single center experience.

J Cardiovasc Med (Hagerstown) 2021 Apr 20. Epub 2021 Apr 20.

Dipartimento di Scienze Cardiovascolari e Toraciche, Fondazione Policlinico Universitario A. Gemelli IRCCS Catholic University of the Sacred Heart Department of Pediatric Cardiology and Cardiac Surgery - Bambino Gesù Hospital, Rome, Italy.

Aim: To summarize our experience on the implementation of a telemedicine service dedicated to adult congenital heart disease (ACHD) patients during the lockdown for the first wave of COVID-19.

Methods: This is a prospective study enrolling all ACHD patients who answered a questionnaire dedicated telematic cardiovascular examination.

Results: A total of 289 patients were enrolled, 133 (47%) were male, 25 (9%) were affected by a genetic syndrome. The median age was 38 (29-51) years, whereas the median time interval between the last visit and the telematic follow-up was 9.5 (7.5-11.5) months. Overall, 35 patients (12%) reported a worsening of fatigue in daily life activity, 17 (6%) experienced chest pain, 42 (15%) had presyncope and 2 (1%) syncope; in addition, 28 patients (10%) presented peripheral edema and 14 (5%) were orthopneic. A total of 116 (40%) patients reported palpitations and 12 had at least one episode of atrial fibrillation and underwent successful electrical (8) or pharmacological (4) cardioversion. One patient was admitted to the emergency department for uncontrolled arterial hypertension, five for chest pain, and one for heart failure. Two patients presented fever but both had negative COVID-19 nasal swab.

Conclusion: During the COVID-19 pandemic, the use of telemedicine dramatically increased and here we report a positive experience in ACHD patients. The postpandemic role of telemedicine will depend on permanent regulatory solutions and this early study might encourage a more systematic telematic approach for ACHD patients.
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http://dx.doi.org/10.2459/JCM.0000000000001195DOI Listing
April 2021

Heart valve critical pathway and heart valve clinic: novel benchmarks for modern management of valvular heart disease.

Crit Pathw Cardiol 2021 Mar 31. Epub 2021 Mar 31.

Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia Università Cattolica del Sacro Cuore, Roma, Italia.

The growing burden of Valvular Heart Disease (VHD) in Western countries represents a challenge for the daily clinical practice, especially in the light of the ever-increasing number of therapeutic options. The Euro Heart Survey showed that, among elderly subjects with severe, symptomatic valve dysfunction, surgery is denied for 33% of patients with aortic stenosis and for 50% of patients with mitral regurgitation. Current management (from diagnosis to follow-up) is often fragmented in multiple - sometimes unnecessary- steps. Such a "patchy" approach may translate into a suboptimal management, especially in the geriatric population. New healthcare models exist, that can coordinate care, reduce fragmentation, limit costs and, ultimately, improve outcomes: the clinical pathways.
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http://dx.doi.org/10.1097/HPC.0000000000000260DOI Listing
March 2021

Minimally Invasive Aortic Valve Surgery in Octogenarians: Reliable Option or Fallback Solution?

Innovations (Phila) 2021 Jan-Feb;16(1):34-42. Epub 2020 Dec 15.

60234 Cardiac Surgery Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.

Objective: Aortic valve disease is more and more common in western countries. While percutaneous approaches should be preferred in older adults, previous reports have shown good outcomes after surgery. Moreover, advantages of minimally invasive approaches may be valuable for octogenarians. We sought to compare outcomes of conventional aortic valve replacement (CAVR) versus minimally invasive aortic valve replacement (MIAVR) in octogenarians.

Methods: We retrospectively collected data of 75 consecutive octogenarians who underwent primary, elective, isolated aortic valve surgery through conventional approach (41 patients, group CAVR) or partial upper sternotomy (34 patients, group MIAVR).

Results: Mean age was 81.9 ± 0.9 and 82.3 ± 1.1 years in CAVR and MIAVR patients, respectively ( = 0.09). MIAVR patients had lower 24-hour chest drain output (353.4 ± 207.1 vs 501.7 ± 229.9 mL, < 0.01), shorter mechanical ventilation (9.6 ± 2.4 vs 11.3 ± 2.3 hours, < 0.01), lower need for blood transfusions (35.3% vs 63.4%, = 0.02), and shorter hospital stay (6.8 ± 1.6 vs 8.3 ± 4.3 days, < 0.01). Thirty-day mortality was zero in both groups. Survival at 1, 3, and 5 years was 89.9%, 80%, and 47%, respectively, in the CAVR group, and 93.2%, 82.4%, and 61.8% in the MIAVR group, with no statistically significant differences (log-rank test, = 0.35).

Conclusions: Aortic valve surgery in older patients provided excellent results, as long as appropriate candidates were selected. MIAVR was associated with shorter mechanical ventilation, reduced blood transfusions, and reduced hospitalization length, without affecting perioperative complications or mid-term survival.
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http://dx.doi.org/10.1177/1556984520974467DOI Listing
December 2020

Extracorporeal membrane oxygenation for COVID-19: effective weapon or futile effort?

Minerva Cardioangiol 2020 Oct;68(5):365-367

Department of Cardiovascular Sciences, IRCCS A. Gemelli University Policlinic Foundation, Rome, Italy.

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http://dx.doi.org/10.23736/S0026-4725.20.05377-3DOI Listing
October 2020

Unexpected diagnosis following screening breast ultrasound.

Clin Case Rep 2020 Oct 1;8(10):2073-2075. Epub 2020 Jun 1.

Department of Cardiovascular Sciences Cardiac Surgery Unit Fondazione Policlinico Universitario "A. Gemelli" IRCCS Rome Italy.

Any instrumental examination may lead to unexpected diagnosis that in turn can radically change the clinical pathway of a patient.
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http://dx.doi.org/10.1002/ccr3.3014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7562835PMC
October 2020

Psychological Effects of Skin Incision Size in Minimally Invasive Valve Surgery Patients.

Innovations (Phila) 2020 Nov/Dec;15(6):532-540. Epub 2020 Sep 28.

Cardiovascular Sciences Department, Agostino Gemelli Polyclinic Foundation IRCSS, Rome, Italy.

Objective: Clinical benefits of minimally invasive cardiac valve surgery (MIVS) have been reported. Improved postoperative mental status was never analyzed with dedicated psychological tests. In the present study we intend to investigate potential benefits of MIVS for patient psychological well-being, with special attention to the relevance of the patient perception of the chest surgical scar, of the self body image and cosmetic aspects.

Methods: Between 2016 and 2017, 87 eligible patients, age 66.5 ± 14.5 years, operated on for heart valve surgery, underwent either conventional full sternotomy (CS; = 48) or MIVS by V-shape hemi-sternotomy approach ( = 39). Before selection of the surgical approach, patients had undergone preoperative evaluation of their psychological status using Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory Form Y (STAI-Y), and EuroQol-5D (EQ-5D) psychological tests. Six months postoperatively, patients filled in dedicated questionnaires to assess their psychological status, quality of life, and subjective perception, thus repeating the above-mentioned tests and adding the Body Image Questionnaire (BIQ) and Patient and Observer Scar Assessment Scale (POSAS) v2.0 tests for scar-healing process evaluation.

Results: No patient died during the study.The 4 post-test scales of psychological well-being (BDI-II = 0.04, STAI-Y = 0.04, 2 indices of EQ-5D = 0.03, = 0.01) showed significant differences between the MIVS group and CS group, with MIVS-small incision patients having lower level of depression and anxiety symptoms and better quality of life. Mean score differences of scar perception (BIQ and POSAS v2.0) were significant, with MIVS patients having evaluated the scar quality significantly better than CS patients.

Conclusions: MIVS appears associated with significant esthetical and related psychological benefits, as documented by technical tests. These findings should be considered when selecting the most appropriate technique for heart valve surgery.
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http://dx.doi.org/10.1177/1556984520956980DOI Listing
September 2020

Delayed massive subcutaneous emphysema following Robicsek closure.

Clin Case Rep 2019 Dec 3;7(12):2588-2589. Epub 2019 Nov 3.

Department of Cardiovascular Sciences Cardiac Surgery Unit Fondazione Policlinico Universitario "A.Gemelli" IRCCS Catholic University of the Sacred Heart Rome Italy.

A surgical procedure may lead to unusual and unexpected clinical scenario. Good medical practice should always keep it in mind. So, a broken sternal steel wire was the rare cause of massive emphysema.
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http://dx.doi.org/10.1002/ccr3.2518DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935661PMC
December 2019

Improved Patient Recovery With Minimally Invasive Aortic Valve Surgery: A Propensity-Matched Study.

Innovations (Phila) 2019 Oct 21;14(5):419-427. Epub 2019 Aug 21.

Department of Cardiovascular Sciences, Cardiac Surgery Unit, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.

Objective: Despite conflicting evidence available, minimally invasive aortic valve replacement (MIAVR) is increasingly used as an alternative to full sternotomy. We sought to compare early outcomes of aortic valve replacement through a full sternotomy (conventional aortic valve replacement [CAVR]) and upper ministernotomy (MIAVR).

Methods: We analyzed 297 patients having undergone primary, elective, isolated MIAVR or CAVR between January 2014 and June 2018. Following propensity score matching, 120 patients remained in each group.

Results: MIAVR required longer bypass (93 ± 26 vs 81 ± 24 minutes, < 0.01) and operative times (214 ± 39 vs 182 ± 37 minutes, < 0.01). However, aortic cross-clamp times were comparable (57 ± 17 vs 54 ± 14 minutes for MIAVR and CAVR, respectively, = 0.14). MIAVR had less 24-hour blood loss (253 ± 204 vs 323 ± 296 mL, = 0.03), less red blood cells transfusions [1.4 packs (1.1 o 1.9) vs 2.1 packs (1.8 to 2.7), = 0.01], and shorter assisted ventilation time (7.1 ± 3.3 vs 9.7 ± 3.8 hours, < 0.01) when compared to CAVR. These results led to significantly shorter intensive care unit and hospital stays for MIAVR patients (2.5 ± 1.3 vs 3.4 ± 1.1 days, < 0.01 and 6.9 ± 4.1 vs 8.2 ± 4.8 days, = 0.03, respectively). Thirty-day mortality and clinical outcomes did not differ significantly among groups.

Conclusions: MIAVR through upper ministernotomy was shown to be as safe and reliable as CAVR. Patient recovery time was improved by shortening mechanical ventilation and reducing blood loss and transfusions. These results may be significant for high-risk patients undergoing aortic valve surgery.
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http://dx.doi.org/10.1177/1556984519868715DOI Listing
October 2019

The "Heart Valve Clinic" Pathway for the Management of Frail Patients With Valvular Heart Disease: From "One for All" to "All for One".

Crit Pathw Cardiol 2019 06;18(2):61-65

From the Cardiovascular Sciences Department, Agostino Gemelli Foundation Polyclinic IRCSS, Catholic University of The Sacred Heart, Rome, Italy.

Valvular heart disease (VHD) is frequently diagnosed in old patients with clinical evidence of heart failure. This elderly population typically presents a high prevalence of frailty and comorbidities, which are associated with increased operative risk for surgical and percutaneous procedures. Recently, the Euro Heart Survey reported a clear gap between treatment guidelines and their application in the "real world". A more realistic approach to the treatment of older VHD patients treatment, mostly if associated with heart failure, is advocated. A multidisciplinary approach, as obtained with the Heart Valve Clinic methodology (intended to put the patient in the "center" of the scene and the specialists "around him"), has been applied in a group of 79 patients, aged >70 years, with symptomatic VHD, divided in 2 groups according to their frailty status (58 robust and 21 frail). No in-hospital mortality and no difference in late mortality and complications were observed. Infections were more frequent (14.3 vs. 1.7 %; P = 0.02) in frail patients. In patients with postoperative complications, serum levels of interleukin 6 (67.6 vs. 49.6; P = 0.01) and of CAF (C-terminal agrin fragment) as sarcopenia marker (67.9 vs. 62.0; P = 0.04) were higher than that in uncomplicated patients. This study was designed to determine the outcomes of the multidimensional geriatric assessment in the management of older patients with heart failure eligible for heart valve surgery. Geriatric assessment and measurement of inflammatory and sarcopenia markers may represent valid tools for a more realistic evaluation of elderly patients with VHD.
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http://dx.doi.org/10.1097/HPC.0000000000000179DOI Listing
June 2019

Aortic Valve Replacement in Elderly Patients With Small Aortic Annulus: Results With Three Different Bioprostheses.

Innovations (Phila) 2019 Feb 7;14(1):27-36. Epub 2019 Mar 7.

1 Cardiovascular Sciences Department, Foundation Polyclinic University A. Gemelli IRCCS, Rome, Italy.

Objectives: Aortic valve replacement (AVR) in patients with small aortic annulus (diameter ≤21 mm) is considered a challenging scenario because of technical aspects and the high risk of patient-prosthesis mismatch (PPM). The choice of the appropriate prosthesis is crucial, and at the moment, an ideal device has yet to be identified. We compare clinical and hemodynamic results after AVR with three bioprostheses with different design and characteristics.

Methods: We retrospectively evaluated 76 consecutive patients from two cardiac surgery centers who underwent AVR (Trifecta = 24; Edwards INTUITY Elite valve system = 26, and Perceval = 26) for severe aortic stenosis between 2013 and 2017. Patients selected were older than 75 years and with an annulus diameter ≤21 mm at preoperative echocardiogram. Reinterventions and combined procedures were excluded. Minimally invasive AVR was performed in 44 (57.8%) patients. Telephonic interview was obtained at 2.9 ± 0.5 years and echocardiographic follow-up at 2.2 ± 0.8 years.

Results: Clinical outcome was similar in the three groups. At follow-up, Trifecta patients presented significantly higher peak and mean transprosthetic pressure gradients ( P = 0.04 and 0.01). Effective orifice area and left ventricular mass regression were comparable, although an advantage was observed in Perceval patients without reaching the statistical significance. Incidence of moderate ( P = 0.2) and severe PPM ( P = 0.7) was comparable.

Conclusions: Despite higher postoperative pressure gradients observed with the Trifecta valve, all three prostheses (Trifecta, Edwards INTUITY Elite, and Perceval) have proven to be reliable when implanted in small aortic annuli, with good clinical outcome and favorable left ventricular mass regression.
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http://dx.doi.org/10.1177/1556984519826430DOI Listing
February 2019

Giant left main coronary artery aneurysm: How to deal with it?

J Thorac Cardiovasc Surg 2019 Mar 29;157(3):e163-e166. Epub 2018 Sep 29.

Cardiovascular Sciences Department, Agostino Gemelli Foundation Policlinic IRCSS, Catholic University of The Sacred Heart, Rome, Italy.

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http://dx.doi.org/10.1016/j.jtcvs.2018.08.099DOI Listing
March 2019

From Cath Lab to Surgery Room.

Circ Cardiovasc Imaging 2018 09;11(9):e008174

Cardiovascular Department, Cardiac Surgery Unit, Fondazione Policlinico A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy (M.M.).

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http://dx.doi.org/10.1161/CIRCIMAGING.118.008174DOI Listing
September 2018

Acute heart failure related to a large left atrial myxoma.

Proc (Bayl Univ Med Cent) 2018 Jul 9;31(3):331-333. Epub 2018 Apr 9.

Cardiovascular Sciences Department, Catholic University of The Sacred Heart, Agostino Gemelli Policlinic, Rome, Italy.

An association between atrial myxoma and left ventricular failure is rarely described, is not completely understood, and may have multiple etiologies. We present a 49-year-old man with no history of cardiovascular disease who was admitted to our hospital with pulmonary edema. He was in atrial fibrillation with rapid ventricular response. Echocardiography showed a 10.5-cm left atrial myxoma, which had been asymptomatic until the onset of congestive heart failure in the presence of severe left ventricular systolic dysfunction. Left ventricular inflow obstruction associated with the giant atrial mass could not be the only cause for acute heart failure.
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http://dx.doi.org/10.1080/08998280.2018.1446641DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5997048PMC
July 2018

Systematic bilateral internal mammary artery grafting: lessons learned from the CATHolic University EXtensive BIMA Grafting Study.

Eur J Cardiothorac Surg 2018 10;54(4):702-707

Department of Cardiovascular Sciences, Catholic University, Rome, Italy.

Objectives: Despite claims of feasibility, to date no study has examined the effect of systematic bilateral internal mammary artery (BIMA) use in a large cohort of real-world unselected patients. The CATHolic University EXtensive BIMA Grafting Study (CATHEXIS) registry was designed to assess the feasibility and safety of systematic BIMA grafting.

Methods: The CATHEXIS was a single-centre, prospective, observational, propensity-matched study. The study was supposed to include 2 arms of 500 patients each: a prospective arm and a retrospective arm. The prospective arm included almost all patients referred for coronary artery bypass grafting (CABG) at our institution after the start of the CATHEXIS with very few exceptions. BIMA would have been used in all these patients. The retrospective arm included patients submitted to CABG before the start of the CATHEXIS and propensity matched to the prospective group (average BIMA use 50%; the radial artery was extensively used). Safety analyses were scheduled after enrolment of 200, 300 and 400 BIMA patients.

Results: After the first 226 patients, the BIMA use percentage was 88.5% (200 of 226). In 178 (89%) patients, mammary arteries were used as Y graft. Postoperative mortality was 2%, and incidence of perioperative myocardial infarction, graft failure and sternal complications were 3.5%, 3% and 5.5%, respectively. No perioperative stroke occurred. The incidence of major adverse cardiac events (particularly graft failure and sternal complications) in the BIMA arm were significantly higher than those in the propensity-matched cohort; the study was stopped for safety.

Conclusions: In a real world setting the systematic use of BIMA was associated with a higher incidence of perioperative adverse events (particularly sternal complications). Individualization of the revascularization strategy and use of alternative arterial conduits are probably preferable to systematic use of BIMA.
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http://dx.doi.org/10.1093/ejcts/ezy148DOI Listing
October 2018

Expect the Unexpected: A Bizarre Lookalike of Left Atrial Tumor.

Ann Thorac Surg 2017 Dec;104(6):e457-e458

Department of Cardiac Surgery, Catholic University of the Sacred Heart, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy.

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http://dx.doi.org/10.1016/j.athoracsur.2017.08.007DOI Listing
December 2017

Fungal Endocarditis Due to Aspergillus oryzae: The First Case Reported in the Literature.

J Heart Valve Dis 2017 03;26(2):205-207

Department of Cardiovascular Sciences, Catholic University of Sacred Heart, Rome, Italy.

Infective endocarditis (IE) is a severe disease with high mortality and morbidity. Prosthetic valve endocarditis is a life-threatening complication which can occur in less than 10% of patients with valve prosthesis. A fungal etiology of IE is rare and accounts for only 2-4% of all case of endocarditis, but is associated with a higher mortality and morbidity. Herein is reported the first case of fungal endocarditis of aortic valve prosthesis due to Aspergillus oryzae in a 67-year-old caucasian man who nine years previously underwent mitral and aortic valve replacement with mechanical prostheses, and tricuspid annuloplasty for acute IE due to Enterococcus spp. Seven months previously, the patient also underwent a redo cardiac procedure to replace a mitral valve prosthesis with a new mechanical device due to a leakage. Aspergillus oryzae showed impressive growth with strong and unexpected virulence in both local and systemic settings.
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March 2017

Risk of Cause-Specific Death in Individuals With Diabetes: A Competing Risks Analysis.

Diabetes Care 2016 Nov 4;39(11):1987-1995. Epub 2016 Aug 4.

Public Health Agency, Government of Catalonia, Barcelona, Spain.

Objective: Diabetes is a common cause of shortened life expectancy. We aimed to assess the association between diabetes and cause-specific death.

Research Design And Methods: We used the pooled analysis of individual data from 12 Spanish population cohorts with 10-year follow-up. Participants had no previous history of cardiovascular diseases and were 35-79 years old. Diabetes status was self-reported or defined as glycemia >125 mg/dL at baseline. Vital status and causes of death were ascertained by medical records review and linkage with the official death registry. The hazard ratios and cumulative mortality function were assessed with two approaches, with and without competing risks: proportional subdistribution hazard (PSH) and cause-specific hazard (CSH), respectively. Multivariate analyses were fitted for cardiovascular, cancer, and noncardiovascular noncancer deaths.

Results: We included 55,292 individuals (15.6% with diabetes and overall mortality of 9.1%). The adjusted hazard ratios showed that diabetes increased mortality risk: 1) cardiovascular death, CSH = 2.03 (95% CI 1.63-2.52) and PSH = 1.99 (1.60-2.49) in men; and CSH = 2.28 (1.75-2.97) and PSH = 2.23 (1.70-2.91) in women; 2) cancer death, CSH = 1.37 (1.13-1.67) and PSH = 1.35 (1.10-1.65) in men; and CSH = 1.68 (1.29-2.20) and PSH = 1.66 (1.25-2.19) in women; and 3) noncardiovascular noncancer death, CSH = 1.53 (1.23-1.91) and PSH = 1.50 (1.20-1.89) in men; and CSH = 1.89 (1.43-2.48) and PSH = 1.84 (1.39-2.45) in women. In all instances, the cumulative mortality function was significantly higher in individuals with diabetes.

Conclusions: Diabetes is associated with premature death from cardiovascular disease, cancer, and noncardiovascular noncancer causes. The use of CSH and PSH provides a comprehensive view of mortality dynamics in a population with diabetes.
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http://dx.doi.org/10.2337/dc16-0614DOI Listing
November 2016

Left ventricular rhabdomyoma in an adult patient: a rare disease successfully treated.

Int J Cardiol 2014 Oct 4;176(3):e107-9. Epub 2014 Aug 4.

Institute of Anatomic Pathology, Catholic University, Rome, Italy.

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http://dx.doi.org/10.1016/j.ijcard.2014.07.244DOI Listing
October 2014

Constrictive pericarditis after cardiac surgery.

Ann Thorac Surg 2013 Feb 22;95(2):731-6. Epub 2012 Dec 22.

Division of Cardiac Surgery, Catholic University, Rome, Italy.

Constrictive pericarditis may develop as a midterm or late complication of cardiac surgery. Owing to limited incidence and scarce reports in the literature the pathophysiologic determinants of such conditions are scarcely known, although a number of mechanisms have been implicated. This disease often poses major diagnostic issues as its clinical picture at presentation is nonspecific, may develop at any moment during the postoperative follow-up, and transthoracic echocardiography may be not suggestive of the diagnosis. The present paper aims at critically revising the available literature on the topic, emphasizing the need to keep a high level of suspicion for all surgeons and physicians involved in the long-term care of cardiac surgery patients.
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http://dx.doi.org/10.1016/j.athoracsur.2012.08.059DOI Listing
February 2013

A case of myocardial infarction effectively treated by emergency coronary stenting soon after a Bentall-De Bono aortic surgery.

Cardiovasc Revasc Med 2010 Oct-Dec;11(4):263.e5-9

Department of Cardiovascular Medicine, Institute of Cardiology, Catholic University, Rome, Italy.

Postoperative ischemia may complicate cardiac surgery, despite myocardial protection and recent technical developments. Its medical management in the intensive cardiac care unit is usually efficient, although sometimes it requires the revision of the surgical site. In other cases, urgent coronary angiography and subsequent coronary stenting may resolve the situation. Ostial stenosis of coronary anastomoses is a well-known uncommon but dramatic complication after aortic surgery causing myocardial ischemia. Cases of effort angina have been described several months after surgery, but in some cases, acute myocardial infarction may occur days or weeks after intervention. We here describe an anteroseptal ST-elevation myocardial infarction soon after a Bentall aortic root replacement due to compression of the left main ostium by surgical glue, which has been effectively treated by emergency coronary stenting. This case highlights the importance of a joint management of acute myocardial ischemia after cardiac surgery by the cardiac surgeon and the interventional cardiologist.
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http://dx.doi.org/10.1016/j.carrev.2009.07.003DOI Listing
February 2011